Common use of ACCOUNTING SUMMARY Clause in Contracts

ACCOUNTING SUMMARY. The Reinsurer requires the Ceding Company to send summary accounting information similar to the following example with each statement: Premiums Allowance Net Premium Totals Total Due First Year Total Base $ 2,300.00 0.00 $ 2,300.00 Cash Value 0.00 ADB 100.00 0.00 100.00 Benefits/Claims 0.00 Waiver 100.00 0.00 100.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ 2,500.00 0.00 $ 2,500.00 Net Premium $ 2,500.00 $ 2,500.00 Renewal Total Base $ 25,000.00 0.00 $ 25,000.00 Cash Value 0.00 ADB 1,000.00 0.00 1,000.00 Benefits/Claims 0.00 Waiver 1,500.00 0.00 1,500.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ 27,500.00 0.00 $ 27,500.00 Net Premium $ 27,500.00 $ 27,500.00 First Year & Renewal Base $ 27,300.00 0.00 $ 27,300.00 Cash Value 0.00 ADB 1,100.00 0.00 1,100.00 Benefits/Claims 0.00 Waiver 1,600.00 0.00 1,600.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ 30,000.00 0.00 $ 30,000.00 Net Premium $ 30,000.00 $ 30,000.00 46 EXHIBIT F — APPLICATION FOR FACULTATIVE REINSURANCE 47 EXHIBIT G — ALLOCATION RULES FOR PLACEMENT OF FACULTATIVE CASES The Ceding Company will place the case with the Reinsurer having the first in best offer. EXHIBIT H — ACCELERATED BENEFIT RIDER

Appears in 1 contract

Samples: Yrt Reinsurance Agreement (Farmers Variable Life Separate Account A)

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ACCOUNTING SUMMARY. The Reinsurer requires the Ceding Company to send summary accounting information similar to the following example with each statement: Premiums Allowance Net Premium Totals Total Due First Year Total Base $ $2,300.00 0.00 $ $2,300.00 Cash Value 0.00 ADB 100.00 0.00 100.00 Benefits/Claims 0.00 Waiver 100.00 0.00 100.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ $2,500.00 0.00 $ $2,500.00 Net Premium $ $2,500.00 $ $2,500.00 Renewal Total Base $ $25,000.00 0.00 $ $25,000.00 Cash Value 0.00 ADB 1,000.00 0.00 1,000.00 Benefits/Claims 0.00 Waiver 1,500.00 0.00 1,500.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ $27,500.00 0.00 $ $27,500.00 Net Premium $ $27,500.00 $ $27,500.00 First Year & Renewal Base $ $27,300.00 0.00 $ $27,300.00 Cash Value 0.00 ADB 1,100.00 0.00 1,100.00 Benefits/Claims 0.00 Waiver 1,600.00 0.00 1,600.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ $30,000.00 0.00 $ $30,000.00 Net Premium $ $30,000.00 $ $30,000.00 46 31 (000) 00000-00-00 05/9/2017 EXHIBIT F – SAMPLE APPLICATION FOR FACULTATIVE REINSURANCE 47 REINSURANCE GROUP OF AMERICA CEDING COMPANY FACSIMILE NUMBER UNDERWRITER E-MAIL TELEPHONE NUMBER BY DATE PROPOSED INSURED (LAST NAME) (FIRST) (MIDDLE) DATE OF BIRTH AGE SEX M F STATE OF BIRTH STATE OF RESIDENCE OCCUPATION BASIS NEAREST BIRTHDAY LAST BIRTHDAY YRT CO-INS AUTOMATIC FACULTATIVE NUMBER OF PAGES LIFE WAIVER ADB PREVIOUS IN FORCE RETENTION CURRENT APPLICATION PROPOSED RETENTION REPLACEMENT? REINSURANCE APPLIED FOR RATING YES NO DOES APPLICATION REPRESENT EXERCISE OF A GUARANTEED INSURABILITY OPTION OR ANY OTHER SPECIAL BENEFIT? WILL POLICY CONTAIN AN AVIATION EXCLUSION PROVISION? IS REINSURANCE BEING SUBMITTED ELSEWHERE? IF YES, WHERE: IN EXCESS OF JUMBO? SMOKING/TOBACCO STATUS NO TOBACCO TOBACCO NONSMOKER SMOKER (000) 00000-00-00 05/9/2017 REQUIREMENTS ATTACHED OUTSTANDING APP EXAM ECG XRAY BLOOD PROF HIV HOS ORAL FLUID APS DR: _________________________________ APS DR: _________________________________ APS DR: _________________________________ INSP/PHI BBIR FINANCIAL REMARKS REFER TO KEEP TOGETHER WITH JOINT LIFE GROUP/BUSINESS/FAMILY NAME DATE OF BIRTH RELATIONSHIP PLEASE INDICATE REASON SUBMITTED AND CODES YOUR COMPANY IS REPORTING TO MIB (000) 00000-00-00 05/9/2017 EXHIBIT G ALLOCATION RULES FOR PLACEMENT OF FACULTATIVE CASES The Ceding Company will place the case with the Reinsurer reinsurer having the first in best offer. (000) 00000-00-00 05/9/2017 EXHIBIT H — ACCELERATED BENEFIT RIDER– JOINT LAST SURVIVOR CONDITIONS For the Joint Last Survivor plan, the Automatic Binding Limit and Jumbo Limit are based on the single life binding limits subject to the following conditions: [REDACTED]

Appears in 1 contract

Samples: Reinsurance Agreement (Symetra Separate Account Sl)

ACCOUNTING SUMMARY. The Reinsurer requires the Ceding Company to send summary accounting information similar to the following example with each statement: Premiums Allowance Net Premium Totals Total Due First Year Total Base $ 2,300.00 0.00 $ 2,300.00 Cash Value 0.00 ADB 100.00 0.00 100.00 Benefits/Claims 0.00 Waiver 100.00 0.00 100.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ 2,500.00 0.00 $ 2,500.00 Net Premium $ 2,500.00 $ 2,500.00 Renewal Total Base $ 25,000.00 0.00 $ 25,000.00 Cash Value 0.00 ADB 1,000.00 0.00 1,000.00 Benefits/Claims 0.00 Waiver 1,500.00 0.00 1,500.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ 27,500.00 0.00 $ 27,500.00 Net Premium $ 27,500.00 $ 27,500.00 First Year & Renewal Base $ 27,300.00 0.00 $ 27,300.00 Cash Value 0.00 ADB 1,100.00 0.00 1,100.00 Benefits/Claims 0.00 Waiver 1,600.00 0.00 1,600.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ 30,000.00 0.00 $ 30,000.00 Net Premium $ 30,000.00 $ 30,000.00 46 47 EXHIBIT F — APPLICATION FOR FACULTATIVE REINSURANCE 47 EXHIBIT G — ALLOCATION RULES FOR PLACEMENT OF FACULTATIVE CASES The Ceding Company 48 Facultative Reinsurance Submission To: (Reinsurance Company) Date: Name of Proposed Insured o Male o Female First Middle Last Birth date Birthplace State of Residence Height Weight B.P. / Pulse / / / Plan Description Beneficiary Relationship Nicotine o Yes o No Adverse data on avocation, occupation, travel, habits, finances? o Yes o No Life Waiver of Premium ADB Previous in force other companies Previous in force FNWL Previous retained by FNWL Previous rating, if substandard Insurance now applied for Amount / % FNWL will place the case with the Reinsurer having the first in best offer. EXHIBIT H — ACCELERATED BENEFIT RIDERretain Rating, if substandard Not Underwriting source Favorable Attached Obtained Comments Application Medical

Appears in 1 contract

Samples: Yrt Reinsurance Agreement (Farmers Variable Life Separate Account A)

ACCOUNTING SUMMARY. The Reinsurer requires the Ceding Company to send summary accounting information similar to the following example with each statement: Premiums Allowance Net Premium Totals Total Due First Year Total Base $ 2,300.00 0.00 $ 2,300.00 Cash Value 0.00 ADB 100.00 0.00 100.00 Benefits/Claims 0.00 Waiver 100.00 0.00 100.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ 2,500.00 0.00 $ 2,500.00 Net Premium $ 2,500.00 $ 2,500.00 Renewal Total Base $ 25,000.00 0.00 $ 25,000.00 Cash Value 0.00 ADB 1,000.00 0.00 1,000.00 Benefits/Claims 0.00 Waiver 1,500.00 0.00 1,500.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ 27,500.00 0.00 $ 27,500.00 Net Premium $ 27,500.00 $ 27,500.00 First Year & Renewal Base $ 27,300.00 0.00 $ 27,300.00 Cash Value 0.00 ADB 1,100.00 0.00 1,100.00 Benefits/Claims 0.00 Waiver 1,600.00 0.00 1,600.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ 30,000.00 0.00 $ 30,000.00 Net Premium $ 30,000.00 $ 30,000.00 46 (460, C01) 10000-00-00 52 12/14/2017 EXHIBIT F — G – SAMPLE APPLICATION FOR FACULTATIVE REINSURANCE 47 REINSURANCE GROUP OF AMERICA CEDING COMPANY FACSIMILE NUMBER UNDERWRITER E-MAIL TELEPHONE NUMBER BY DATE PROPOSED INSURED (LAST NAME) (FIRST) (MIDDLE) DATE OF BIRTH AGE SEX STATE OF BIRTH STATE OF RESIDENCE OCCUPATION ☐ M ☐ F BASIS ☐ AUTOMATIC NUMBER OF PAGES ☐ NEAREST BIRTHDAY ☐ YRT ☐ FACULTATIVE ☐ LAST BIRTHDAY ☐ CO-INS LIFE WAIVER ADB REQUIREMENTS PREVIOUS IN FORCE ATTACHED OUTSTANDING RETENTION APP ☐ ☐ CURRENT APPLICATION EXAM ☐ ☐ PROPOSED RETENTION ECG ☐ ☐ REPLACEMENT? XRAY ☐ ☐ REINSURANCE APPLIED FOR BLOOD ☐ ☐ RATING PROF HIV ☐ ☐ YES NO HOS ☐ ☐ DOES APPLICATION REPRESENT EXERCISE OF A GUARANTEED INSURABILITY OPTION OR ANY OTHER SPECIAL BENEFIT? ORAL FLUID ☐ ☐ WILL POLICY CONTAIN AN AVIATION EXCLUSION PROVISION? APS ☐ ☐ IS REINSURANCE BEING SUBMITTED ELSEWHERE? DR: IF YES, WHERE: IN EXCESS OF JUMBO? SMOKING/TOBACCO STATUS APS ☐ ☐ ☐ NO TOBACCO ☐ NONSMOKER DR: ☐ TOBACCO ☐ SMOKER APS ☐ ☐ REMARKS DR: REFER TO INSP/PHI ☐ ☐ KEEP TOGETHER WITH ☐JOINT LIFE ☐ GROUP/BUSINESS/FAMILY NAME DATE OF BIRTH RELATIONSHIP BBIR FINANCIAL ☐ ☐ ☐ ☐ PLEASE INDICATE REASON SUBMITTED AND CODES YOUR COMPANY IS REPORTING TO MIB (460, C01) 10000-00-00 53 12/14/2017 EXHIBIT G — H – ALLOCATION RULES FOR PLACEMENT OF FACULTATIVE CASES The Ceding Company will place the case with the Reinsurer reinsurer having the first in best offer. (460, C01) 10000-00-00 54 12/14/2017 EXHIBIT H — ACCELERATED BENEFIT RIDERI – HIGH NET WORTH FOREIGN NATIONAL PROGRAM The Ceding Company’s High Net Worth Foreign National Program is a formal program under which business is solicited from non-U.S. citizens and non-permanent residents (i.e., non-Green Card holders) with temporary visas associated with residency in the Standard “A” countries/ jurisdictions specified in Exhibit J, Countries Eligible for Automatic Binding of High Net Worth Foreign Nationals. All solicitations of insurance products must be made within the U.S. (U.S. embassies will not be accepted). The Reinsurer and the Ceding Company agree that the Ceding Company’s High Net Worth Foreign National business will be automatically reinsured under the terms of this Agreement except for the following differences:

Appears in 1 contract

Samples: Reinsurance Agreement (Penn Mutual Variable Life Account I)

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ACCOUNTING SUMMARY. The Reinsurer requires the Ceding Company to send summary accounting information similar to the following example with each statement: Premiums Allowance Net Premium Totals Total Due First Year Total Base $ $2,300.00 0.00 $ $2,300.00 Cash Value 0.00 ADB 100.00 0.00 100.00 Benefits/Claims 0.00 Waiver 100.00 0.00 100.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ $2,500.00 0.00 $ $2,500.00 Net Premium $ $2,500.00 $ $2,500.00 Renewal Total Base $ $25,000.00 0.00 $ $25,000.00 Cash Value 0.00 ADB 1,000.00 0.00 1,000.00 Benefits/Claims 0.00 Waiver 1,500.00 0.00 1,500.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ $27,500.00 0.00 $ $27,500.00 Net Premium $ $27,500.00 $ $27,500.00 First Year & Renewal Base $ $27,300.00 0.00 $ $27,300.00 Cash Value 0.00 ADB 1,100.00 0.00 1,100.00 Benefits/Claims 0.00 Waiver 1,600.00 0.00 1,600.00 Policy Fee 0.00 Other 0.00 0.00 0.00 Dividend 0.00 Prem Tax 0.00 Total $ $30,000.00 0.00 $ $30,000.00 Net Premium $ $30,000.00 $ $30,000.00 46 44 EXHIBIT F — G – APPLICATION FOR FACULTATIVE REINSURANCE 47 EXHIBIT G — H – ALLOCATION RULES FOR PLACEMENT OF FACULTATIVE CASES The Ceding Company will place the case with the Reinsurer having the first in best offer. EXHIBIT H — ACCELERATED BENEFIT RIDER00000-00-00 ADDENDUM to the AUTOMATIC/FACULTATIVE YRT REINSURANCE AGREEMENT Effective November 1, 2005 between NATIONAL LIFE INSURANCE COMPANY, Montpelier, Vermont (hereinafter called the “Ceding Company”) and REINSURER (hereinafter called the “Reinsurer”) This Addendum is Effective October 1, 2005

Appears in 1 contract

Samples: Automatic/Facultative Yrt Reinsurance Agreement (National Variable Life Insurance Account)

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